AB1378 RELATION BETWEEN SHARP SCORE AND RADIOLOGICAL PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE OBSERVATION
Authors: O. Alekseeva, D. Kudinsky, A. Smirnov, A. Volkov, E. Nasonov
Journal: Annals of the Rheumatic Diseases (2022)

Objectives to analyse rheumatoid arthritis (RA)-patients depending on their individual peak radiographic progression. Methods 61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to the Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (7 years FUP, median 7,7 [7,4;8,6]). The general characteristics of the group are presented in the Table 1. Hands and feet ultrasound (US) with grayscale (GS), power Doppler (PD), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9, and 12 months after. Radiographs were obtained at baseline, at 12 months, 4 years, and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Structural damage progression was evaluated by change in the Sharp van der Heijde score (ΔSHS) between baseline and 1,4 and 7 year. We determined the individual peak radiographic progression (Δ SHS scores/time) in RA- patients. Table 1. General characteristics Characteristic At baseline After 1 year follow-up After 4 years follow-up After 7 years follow-up Median age, years 50,0 [38,0; 59,0] Disease duration, months 7 [4; 20] GS 6 [4; 9] PD 2 [1; 6] DAS 28 5,6 [4,8; 6,5] 2,88 [2,02; 3,93] 3,76 [2,94; 5,09] 4,03 [3,42; 4,74] ESR, mm/h 35,0 [13,0; 50,0] 12,0 [8,0; 28,0] 22,0 [14,0; 36,0] 22,0 [14,0; 36,0] CRP, mg/l 10,6 [3,8; 32,3] 2,9 [1,1; 7,1] 3,0 [1,2; 8,8] 3,0 [1,2; 8,8] Rheumatoid Factor, positive results 53 (87%) Anti-CPA, positive results 52 (85%) Erosion score 0 [0; 3] 1 [0; 4] 2 [0; 6] 3 [1; 11] Joint-space narrowing score 57,0 [31,0; 88,0] 62,0 [31,0; 92,0] 93,0 [77,0; 106,0] 98,0 [77,0; 110,0] Modified total Sharp score 70,0 [31,0; 88,0] 71,0 [31,0; 93,0] 97,0 [79,0; 112,0] 102,0 [78,0; 117,0] Results RA progression by 1 years FUP was identified in 10% (6 p) of pts, 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts. All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). In the group Rg + GS at baseline was significantly higher than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04). We analyzed relation between SHS (erosion score and total Sharp score) 7 years FUP, individual peak radiographic progression and Δ erosion score and total Sharp score in the observation periods: 0-1 years, 1-4 years, 4-7 years and 0-7 years. The following correlations were identified of erosion score 7 years FUP with Δ erosion score in all observation periods (r=0,33 p=0,016, r=0,54 p=0,000, r=0,68 p=0,000, r=0,84 p=0,000, respectively) and with individual peak radiographic progression in the observation periods 1-4 years, 4-7 years, 0-7 years (r=0,54 p=0,000, r=0,49 p=0,000, r=0,84 p=0,000, respectively). The following correlations were identified of total Sharp score 7 years FUP with Δ total Sharp score in the observation periods 4-7 years, 0-7 years (r=0,43 p=0,000, r=0,34 p=0,007, respectively) and with individual peak radiographic progression in the observation periods 4-7 years, 0-7 years (r=0,43 p=0,000, r=0,34 p=0,007, respectively). Conclusion These data show that the radiological progression increases over time at different rates. Disclosure of Interests None declared